Basic Information
Provider Information
NPI: 1679939391
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: LOWRANCE
FirstName: CARA
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: N.P.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 21333 HAGGERTY RD
Address2: SUITE 150
City: NOVI
State: MI
PostalCode: 483755510
CountryCode: US
TelephoneNumber: 2486620250
FaxNumber: 2486629845
Practice Location
Address1: 811 N 9TH ST
Address2:  
City: SAINT JOSEPH
State: MO
PostalCode: 645011651
CountryCode: US
TelephoneNumber: 8162335164
FaxNumber:  
Other Information
ProviderEnumerationDate: 01/11/2016
LastUpdateDate: 01/11/2016
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LF0000X2016000448MOY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily

No ID Information.


Home